Conditions & Treatments


Sesamoids are two small bones situated below the first metatarsal joint of the big toe in the ball of the foot. The sesamoids are embedded in the tendon under the joint, and act like a pulley in providing a smooth surface over which the tendon slides. Like other bones, sesamoids can fracture. The tendon and tissue around the sesamoid can become inflamed, and this is called a sesamoiditis. In chronic fractures, the sesamoids can lose some of their blood supply–this is called avascular necrosis. Fracture or inflammation can be caused by an injury, repetitive impact exercises, or change in shoe-wear such as a new heeled shoe.

Diagnosis is often made by exam, X-rays, and sometimes MRI.  Pain is often localized under the big toe joint. Treatment initially can be cast, walking boot, or metatarsal pad. Surgery is indicated for chronic pain, and involves removing the whole bone(sesamoidectomy.) Post surgery course typically involves a splint for 2 weeks then a walking boot for up to six weeks.


Foot Fracture Fixation

Foot fractures are breaks that occur in the bones of the feet, and it is these bones that provide the body with vital support and the ability to move comfortably. Foot fracture fixation consists of a wide variety of surgical treatments to relieve discomfort following a foot fracture.  Foot fractures may occur in any of the three main parts of the foot: the hindfoot, consisting of the heel bone and talus, the midfoot, comprised of the small bones between the heel and toes; and the forefoot, where the toes are located.

For undisplaced fractures, treatment typically involves nonsurgical treatments. These may include wearing a cast or boot, taking anti-inflammatory medicine, avoiding strenuous activities or exercises, applying ice, walking with crutches to reduce pressure on the foot and nonsurgical realignment of the bone.

Foot fracture fixation may be necessary for more serious and displaced fractures. Foot fracture fixation surgery involves making an incision and realigning the bone. Once the bone has been properly positioned, metal plates and screws are affixed to keep the bone immobile until it has healed. Each type of foot fracture is unique is terms of protection and recovery time.

Patients often benefit from physical therapy after a foot fracture fixation procedure, as it can help restore strength and function to the foot.

Foot Revision Surgery

Foot injuries are common, especially among athletes. They can be caused by a variety of factors, including trauma, a fall or overuse. Many cases of foot injuries require surgery to relieve persistent pain, correct deformity and restore function to weakened or damaged joints in the foot. While foot surgery is considered safe and effective, not every patient who undergoes surgery will experience a positive outcome. If the patient continues to suffer from problems related to the foot injury, such as debilitating pain, foot revision surgery may be necessary to improve the results of the unsuccessful procedure.

Foot revision surgery may involve repairing or repositioning tendons or ligaments within the foot or around the toes, removing misaligned or damaged joint surfaces or surgically realigning damaged or misplaced joints. In some cases, internal fixation devices that were used during the initial procedure to maintain the proper position of a bone may be removed during foot revision surgery, especially if they causing pain.

Foot revision surgery generally takes longer to complete than an initial foot surgery, and is often more challenging since there is a greater risk of complications. Some complications associated with revision procedures include failure of bones to heal properly, postoperative infection and damage to nerves or blood vessels. Recovery from foot revision surgery usually takes the same length of time as that of the first procedure, and often requires protecting the foot with a boot or brace as well as weight bearing restrictions.

My practice has a vast experience in revising or salvaging difficult problems, and will develop best plan in improving quality of life.